Reviewed by Anthony Howe, Licensed Insurance Agent, NPN #20649362. Updated October 23, 2026, with what changes in Medicare for 2027.
Medicare is the federal health insurance program for people 65 and older and for younger people with certain disabilities. If you live in Oceanside, your Medicare choices depend a lot on where you already get care, whether that’s Tri-City Medical Center, Scripps, Sharp, Kaiser Permanente or Palomar Health.
The parts of Medicare
- Part A covers hospital stays, skilled nursing care and hospice.
- Part B covers doctor visits, outpatient care, tests and preventive services.
- Part C (Medicare Advantage) plans from private insurers provide Part A and Part B benefits, and most include drug coverage.
- Part D covers prescription drugs, through a stand-alone plan or a Medicare Advantage plan.
- Medicare Supplement (Medigap) isn’t a part of Medicare. It’s private insurance that helps pay what Original Medicare leaves to you, and it isn’t the same thing as Medicare Advantage.
Two ways to get your coverage
Original Medicare with a Medicare Supplement (Medigap) plan. You can see any provider in the country that accepts Medicare. A Medigap plan helps pay the deductibles, copays and coinsurance that Original Medicare leaves to you, and you add a separate Part D plan for prescriptions.
Medicare Advantage. One plan from a private insurer covers your Part A and Part B benefits, usually your drugs, and sometimes dental, vision and hearing. Plans use networks, so the doctors and hospitals you can use depend on the plan, and you pay copays up to a yearly out-of-pocket maximum.
Each approach can suit different people. The comparison usually comes down to your doctors, your prescriptions, how much you travel and how you prefer to pay for care.
Key dates for 2027 coverage
- Annual Enrollment Period: October 15 to December 7, 2026. Changes take effect January 1, 2027.
- Medicare Advantage Open Enrollment Period: January 1 to March 31, 2027, for one change if you’re in a Medicare Advantage plan.
- Initial Enrollment Period: the seven months around your 65th birthday, if you’re new to Medicare.
- Medigap open enrollment: the six months that start when you’re both 65 or older and enrolled in Part B. During it, a Medigap insurer can’t turn you down or charge more because of your health.
- California Medigap birthday rule: 60 days starting on your birthday to switch to a Medigap plan with the same or fewer benefits, without health questions.
Common questions
How much does Medicare cost?
Most people pay no premium for Part A. Part B has a standard monthly premium set each year; it is $202.90 in 2026, and the 2027 amount is usually announced in the fall. Medigap, Part D and Medicare Advantage plans have their own premiums, which vary by plan. For drug coverage in 2027, the most a plan can charge as a deductible is $700, and what you pay for covered drugs is capped at $2,400 for the year. Medicare.gov lists current costs.
What’s changing in Medicare for 2027?
The drug cap rises from $2,100 to $2,400, and the maximum drug deductible from $615 to $700. Negotiated prices begin for 15 more drugs, including Ozempic, Wegovy and Trelegy Ellipta. Medicare Advantage plans can handle prior authorization electronically. Eligibility rules for some noncitizens are also narrowing. Our Annual Enrollment Period guide covers each change.
Does Original Medicare cover prescriptions?
Only in limited cases, such as drugs given in a hospital or a doctor’s office. For prescriptions you fill at a pharmacy, you need Part D or a Medicare Advantage plan that includes drug coverage.
Can I keep my doctors?
With Original Medicare, you can see any doctor who accepts Medicare. With Medicare Advantage, check that your doctors and the hospital you would use are in the plan’s network for the coming year, because networks can change. Ask about the specific plan by name: an office that accepts Medicare isn’t automatically in every Medicare Advantage network.
Can I see my doctor by video from home?
Through December 31, 2027, eligible Medicare telehealth services can be received anywhere in the U.S., including at home in Oceanside. Not every service qualifies, and each provider decides whether to offer video visits, so it’s worth asking your doctor’s office.
Where can I get help in Oceanside?
- The Medicare Plan Finder on Medicare.gov, which compares plans using your own drug list and pharmacy.
- 1-800-MEDICARE (1-800-633-4227), available 24 hours a day.
- HICAP, California’s free Medicare counseling program: 1-800-434-0222.
- A licensed agent. Rock Meadow compares plans from the insurers we represent, at no charge to you. Call (760) 654-6760.
Rock Meadow’s office is in Oceanside. For more on local plans and providers, see Medicare in Oceanside.
